Individual
THERESA KOBUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
94 MAIN STREET, SAINT MICHAEL, AK 99659
(907) 923-3311
(907) 923-2287
Mailing address
94 MAIN STREET, SAINT MICHAEL, AK 99659
(907) 923-3311
(907) 923-2287
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
12-1218-III
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12-1218-III
CHA III
AK
Enumeration date
12/27/2013
Last updated
12/27/2013
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